P1734: LESSONS FROM HIV- HAEMOPHILIA CRISIS AND CURRICULAR LEARNING IN POST COVID TIMES
Authors: M. Sekhar, C. Merrion, S. Jadhav
Journal: HemaSphere (2022)

Background: The COVID19 pandemic has posed challenges to clinical decision-making in the context of prolonged uncertainties in clinical, scientific and social areas. The HIV pandemic of 1980s represents a similar period with data and insights acquired over years. Haematologists are familiar with the notion of uncertainty. In particular, haemophilia care during the early 1980s posed specific and unique problems in clinical decision-making. An understanding of professional and personal concerns faced by doctors at the time can contribute to learning and continued professional development. Aims: Compile, structure and analyse audio interviews from physicians involved in haemophilia care in the 80s to generate learning material for curricular learning. Methods: Between June and November 2019 oral history interviews were conducted using a semi-structured questionnaire with 16 senior haemophilia doctors (13 male, 3 female) from Australia, Canada, France, Italy, Netherlands. 28 person-hours of interview material was analysed using pre-established criteria1. Audio recordings and transcripts from UK Infected Blood Inquiry2 held between October 2020 and January 2021 were analysed for content. 18 oral evidences comprising approximately 286 person-hours were examined to extract themes addressing difficulties and dilemmas in clinical decision-making. Following ethical approval, an audio-podcast series3 was produced to address specific domains and themes. Results: Audio material was compiled into segments of audio clips that identified topics across four areas of practice: diagnostic tests, clinical decision making, shared axes of care and personal experiences of adverse outcomes. Material from 6 oral history interviews (Italy, France, Netherlands) was compiled to illustrate cross-national themes and personal dilemmas. These themes were mapped on relevant curricular domains defined by the GMC. (Table 1) The compilation was interspersed with an audio commentary by the first author and published as a podcast series comprising 8 podcasts over approximately 4 hours. Access was via free public platforms. Between November 2021 and February 2022, 472 downloads were documented on one of four platforms. Six medical students and six faculty provided triangulation including feedback. Their feedback confirmed the pedagogic relevance of these podcasts for undergraduate students across years 1 to 5 as part of curricular learning. Feedback from postgraduate trainees in Haematology, other specialities and consultants confirmed the relevance of this material in their continued professional development. Image:Summary/Conclusion: •Our study generates data that contribute to future research on physicians exposed to prolonged uncertainties in clinical and laboratory practice. •Lessons from haemophilia-AIDS crisis are relevant for some aspects of COVID19pandemic. •Recent history of medical events provides a valuable resource to enhance teaching. •Oral history interviews and oral evidence submitted at an inquiry differ in nature but provide complimentary insights. •Podcasts can provide an effective platform for curricular and self-directed learning for graduate and postgraduate learning, worldwide. •A structured platform to catalogue difficult decisions can provide haematologists and others a frame of reference in making difficult decisions. Future research could address the scope and applicability of this pragmatic approach to history of medicine. Ref: 10.1111/hae1.3967 https://www.infectedbloodinquiry.org.uk/ https://thebitterpillpodcasts.libsyn.com